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    OpenPayerNPI Medicare & MedicaidAvera Home Medical Equipment, LLC
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    Avera Home Medical Equipment, LLC — Billing Profile & Reimbursement Data

    NPI 1902972334 · Sioux Falls, SD · Durable Medical Equipment & Medical Supplies

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    Avera Home Medical Equipment, LLC is a durable medical equipment & medical supplies provider located in Sioux Falls, South Dakota. This profile covers 0 Medicare and 60 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationAvera Home Medical Equipment, LLC
    Address3720 W 69th St Ste 100
    CitySioux Falls
    StateSD
    ZIP57108
    TaxonomyDurable Medical Equipment & Medical Supplies
    NPI EnumeratedNovember 28, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$3.4M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    60 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    E1390Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate6,440$60$367.3K
    B4160Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,…2,680$130$356.7K
    B4035Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape2,450$140$353.2K
    T4522Adult sized disposable incontinence product, brief/diaper, medium, each1,330$120$160.6K
    T4523Adult sized disposable incontinence product, brief/diaper, large, each1,340$120$154K
    T4526Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each1,660$90$152.7K
    T4527Adult sized disposable incontinence product, protective underwear/pull-on, large size, each1,530$100$147.3K
    E0601Continuous positive airway pressure (CPAP) device4,220$30$130.9K
    T4528Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each1,260$100$128.9K
    A7030Full face mask used with positive airway pressure device, each1,900$60$111.9K

    Showing 1–10 of 60

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other South Dakota providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. South Dakota median

    60 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    B4161Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding…210630$390$243.7K
    S9977Meals, per diem, not otherwise specified410850$130$158.6K
    B4035Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape310280$130$151.4K
    B4160Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals,…110180$140$120.4K
    E1390Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate340360$50$88.1K
    T4535Disposable liner/shield/guard/pad/undergarment, for incontinence, each510490$60$87.6K
    T4527Adult sized disposable incontinence product, protective underwear/pull-on, large size, each310400$70$80.5K
    T4526Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each320250$80$79.8K
    T4523Adult sized disposable incontinence product, brief/diaper, large, each110690$110$76.9K
    E1028Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other3101,290$40$75.9K

    Showing 1–10 of 60

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Avera Home Medical Equipment, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Avera Home Medical Equipment, LLCSDDurable Medical Equipment & Medical Supplies$0$908.9K
    Avera Home Medical Equipment, LLCSDDurable Medical Equipment & Medical Supplies$0$439.8K
    Avera Home Medical Equipment, LLCSDDurable Medical Equipment & Medical Supplies$0$431.1K
    Avera Home Medical Equipment, LLCSDDurable Medical Equipment & Medical Supplies$0$319.5K
    Avera Home Medical Equipment, LLCSDDurable Medical Equipment & Medical Supplies$0$219.3K
    Avera Home Medical Equipment, LLCSDDurable Medical Equipment & Medical Supplies$0$56.8K
    Avera Home Medical Equipment, LLCSDDurable Medical Equipment & Medical Supplies$0$41.4K

    Nearby Providers

    Other providers in the same ZIP code as Avera Home Medical Equipment, LLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Avera MckennanSDPsychiatry Physician$0$9.1M
    Vance Thompson Vision Surgery Center Prof LLCSDAmbulatory Surgical Clinic/Center$4.5M$22.7K
    Siouxland Oral SurgerySDOral and Maxillofacial Surgery (Dentist)$0$3.9M
    Ryan GeraetsSDOphthalmology Physician$3M$0
    Anderson-smith Speech Therapy, LLCSDSpeech-Language Pathologist$0$1.9M
    Ophthalmology Ltd Eye Surgery Center L L CSDAmbulatory Surgical Clinic/Center$1.8M$16.2K
    Elizabeth AtchisonSDOphthalmology Physician$1.7M$0
    Dakota Vision Center, LLCSDOptometrist$0$1.2M
    Usc Ambulatory Surgical Center Prof LLCSDAmbulatory Surgical Clinic/Center$1.1M$44.2K
    Avera MckennanSDPhysical Therapist$0$1M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. South Dakota Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. South Dakota Distribution
    Avera Home Medical Equipment, LLC — 11 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — South Dakota